慢性腎臟病患者骨病變的診斷與治療

Bone Disorders in Chronic Kidney Disease: Diagnosis and Management

蔡宛蓉(Wan-Jung Tasi) ； 陳建良(Chien-Liang Chen)

《腎臟與透析》 29卷4期 (2017/12) Pp. 165-168

https://doi.org/10.6340/KD.2017.29(4).04

摘要

慢性腎臟疾病骨病變與一般人口相比，骨折風險增加2~14倍。慢性腎臟疾病骨病變會增加病人骨折率和死亡率；因此，適當的篩選慢性腎臟疾病骨併發症的治療至關重要。經髂骨稜切片加上四環素標定與組織形態學測定是用於診斷慢性腎臟疾病骨病變的黃金準則。然而，臨床骨頭切片不常用於所有病人。因此，如何使用非侵入性檢查來看慢性腎臟疾病病人骨病變是很重要的。在這裡，我們介紹如何治療慢性腎臟疾病骨病變，如藉著評估骨轉換生物標誌及結合骨骼的測量如雙重能量X光吸收光譜和新穎的電腦斷層檢查來評估慢性腎臟疾病骨病變。

關鍵字

骨病變 ； 慢性腎臟病 ； 骨折

並列摘要

The bone disorder occurs in chronic kidney disease (CKD) patients associated with 2- to 14-fold increased fracture risk compared to the general population. Bone disorders in CKD patients increased fracture rate and mortality; thus, proper management of bone disorders in CKD patients is critical to improving outcome. Tetracycline double-labeled transiliac crest bone biopsy with histomorphometry study is the gold standard for the diagnosis of bone disorders in CKD. However, bone biopsy is not practical in clinical practice. Thus, there is great interest in noninvasive approaches that can be used to assess bone disorders in patients with CKD. Here, we discuss the strategies about the managements bone disorders in CKD patient by surrogate measures of such as dual energy X-ray absorptiometry and novel high-resolution computed tomography imaging, in conjunction with biochemical biomarkers of bone turnover.

並列關鍵字

bone disorder ； chronic kidney disease ； fracture